Factors associated with reported likelihood to get vaccinated for COVID-19 in a nationally representative US survey.

OBJECTIVES: Although general principles related to vaccination hesitancy have been well researched, reports on reluctance to be vaccinated for coronavirus disease 2019 (COVID-19) in the United States are somewhat surprising, given the disease's substantive disruption of everyday life. However, the landscape in which people are making COVID-19 vaccination decisions has recently evolved with releases of encouraging vaccine-related data and changes to official messaging about the virus. Therefore, this study sought to identify factors associated with reported likelihood to get vaccinated for COVID-19 among US adults in late January 2021. STUDY DESIGN: We used the Prolific online research panel to survey a nationally representative sample of 1017 US adults. METHODS: Respondents were asked about their behavioral intentions toward COVID-19 vaccination, trust in science, perceptions related to COVID-19, and selected sociodemographic factors. We computed associations between those 11 independent variables and likelihood to get vaccinated for COVID-19 using multiple linear regression. RESULTS: Around 73.9% of respondents indicated at least some likelihood to get vaccinated for COVID-19. Trust in science and perceived seriousness of COVID-19 were positively associated with intention to get vaccinated, and identifying as Black or African American was negatively associated with intention to get vaccinated. Other factors were moderately, weakly, or not at all associated with intention. CONCLUSIONS: Building trust in science and truthfully emphasizing the seriousness of catching COVID-19 should be further researched for their potential to support campaigns to encourage COVID-19 vaccination. Data continue to suggest the importance of dialogue with Black communities about COVID-19 vaccination.

A common variant in RAB27A gene is associated with fractional exhaled nitric oxide levels in adults.

BACKGROUND: Exhaled nitric oxide (FeNO) is a biomarker for eosinophilic inflammation in the airways and for responsiveness to corticosteroids in asthmatics. OBJECTIVE: We sought to identify in adults the genetic determinants of fractional exhaled nitric oxide (FeNO) levels and to assess whether environmental and disease-related factors influence these associations. METHODS: We performed a genome-wide association study of FeNO through meta-analysis of two independent discovery samples of European ancestry: the outbred EGEA study (French Epidemiological study on the Genetics and Environment of Asthma, N = 610 adults) and the Hutterites (N = 601 adults), a founder population living on communal farms. Replication of main findings was assessed in adults from an isolated village in Sardinia (Talana study, N = 450). We then investigated the influence of asthma, atopy and tobacco smoke exposure on these genetic associations, and whether they were also associated with FeNO values in children of the EAGLE (EArly Genetics & Lifecourse Epidemiology, N = 8858) consortium. RESULTS: We detected a common variant in RAB27A (rs2444043) associated with FeNO that reached the genome-wide significant level (P = 1.6 × 10(-7) ) in the combined discovery and replication adult data sets. This SNP belongs to member of RAS oncogene family (RAB27A) and was associated with an expression quantitative trait locus for RAB27A in lymphoblastoid cell lines from asthmatics. A second suggestive locus (rs2194437, P = 8.9 × 10(-7) ) located nearby the sodium/calcium exchanger 1 (SLC8A1) was mainly detected in atopic subjects and influenced by inhaled corticosteroid use. These two loci were not associated with childhood FeNO values. CONCLUSIONS AND CLINICAL RELEVANCE: This study identified a common variant located in RAB27A gene influencing FeNO levels specifically in adults and with a biological relevance to the regulation of FeNO levels. This study provides new insight into the biological mechanisms underlying FeNO levels in adults.

Substance use and HIV risks among male heterosexual and 'money boy' migrants in Shanghai, China.

There is a growing awareness that internal migration in China might shift the HIV epidemic by broadening the social and sexual mixing of its population. However, little is known about how drug use/abuse might contribute to the spread of HIV. This qualitative study aims to elucidate factors for preventing substance abuse and HIV among two types of male migrants living in the Shanghai metropolitan area; the general migrant population and so-called 'money boys' (those who engaged in same-sex activities for money). Compared to most male migrants, the 'money boys' had a slightly better economic situation; rarely visited their hometowns; used alcohol less but drugs more; had more knowledge about HIV and sexually transmitted diseases; higher HIV/ STD testing rates and fewer HIV risk behaviors. The general male migrants had more misconceptions about HIV (e.g. the need to pay for HIV testing) than the 'money boys'. However, it was noted that 'money boys' who were new to the enterprise and men who have sex with men but did not engage in commercial sex often lacked HIV knowledge and protective skills. Given the needs of various sub-types of 'migrants', differential approaches to HIV prevention are needed.

Sequence diversity and haplotype structure at the human CYP3A cluster.

The four members of the human CYP3A subfamily play important roles in the clearance of xenobiotics, hormones, and environmental compounds. Many SNPs at the CYP3A locus have been characterized, with several showing large allele frequency differences across populations. In addition to the effects of CYP3A SNPs on drug metabolism, recent studies have highlighted the potential for CYP3A variation in susceptibility to several common phenotypes, including hypertension and cancer. We previously showed that the CYP3A4 and CYP3A5 genes have a strong haplotype structure at varying frequencies across ethnic groups. Here, we extend our re-sequencing survey to the remaining CYP3A genes in the same cluster, CYP3A7 and CYP3A43. Our study identified a large number of SNPs in coding and conserved noncoding sequences, several of which are common. The combined data set allows us to investigate patterns of sequence variation and linkage disequilibrium at the entire CYP3A locus for use in future association studies.

CYP3A variation and the evolution of salt-sensitivity variants.

Members of the cytochrome P450 3A subfamily catalyze the metabolism of endogenous substrates, environmental carcinogens, and clinically important exogenous compounds, such as prescription drugs and therapeutic agents. In particular, the CYP3A4 and CYP3A5 genes play an especially important role in pharmacogenetics, since they metabolize >50% of the drugs on the market. However, known genetic variants at these two loci are not sufficient to account for the observed phenotypic variability in drug response. We used a comparative genomics approach to identify conserved coding and noncoding regions at these genes and resequenced them in three ethnically diverse human populations. We show that remarkable interpopulation differences exist with regard to frequency spectrum and haplotype structure. The non-African samples are characterized by a marked excess of rare variants and the presence of a homogeneous group of long-range haplotypes at high frequency. The CYP3A5*1/*3 polymorphism, which is likely to influence salt and water retention and risk for salt-sensitive hypertension, was genotyped in >1,000 individuals from 52 worldwide population samples. The results reveal an unusual geographic pattern whereby the CYP3A5*3 frequency shows extreme variation across human populations and is significantly correlated with distance from the equator. Furthermore, we show that an unlinked variant, AGT M235T, previously implicated in hypertension and pre-eclampsia, exhibits a similar geographic distribution and is significantly correlated in frequency with CYP3A5*1/*3. Taken together, these results suggest that variants that influence salt homeostasis were the targets of a shared selective pressure that resulted from an environmental variable correlated with latitude.

Clinician attributions associated with the diagnosis of schizophrenia in African American and non-African American patients.

The authors examined the schizophrenia diagnosis in 292 psychiatric inpatients in a largely African American community. Clinicians completed a free-response questionnaire that described their diagnostic decisions. Psychotic symptoms such as hallucinations, which were attributed to African American and non-African American patients at different rates, did not necessarily correspond to differences in diagnostic rates. Rather, symptoms not differentially attributed between groups often corresponded with higher rates of schizophrenia for African American patients. Attributions of negative symptoms showed the largest differences between African American and non-African American patients in rates of schizophrenia diagnosis; thought disorder equalized rates of the diagnosis between the 2 groups of patients. Logistic regression analyses suggested that different aggregate decision models were applied to patients of differing race.

Psychiatric diagnosis of African Americans: diagnostic divergence in clinician-structured and semistructured interviewing conditions.

This study is a primary data collection that varied patient race and diagnosis and used two diagnostic interviewing conditions: one clinician-structured (phase one) and the other a semi-structured diagnostic instrument (phase two). Four basic research questions are addressed: What is the relationship between race and the hospital diagnosis? How is race related to diagnosis in both research interviewing conditions? Why does diagnostic concordance between the hospital diagnosis and the research diagnosis vary by research interviewing condition? Is diagnostic concordance between the hospital and research diagnosis influenced by patient race? A total of 291 patients completed an interview during phase one, while 665 patients completed an interview during phase two. Blacks were more likely to receive a hospital diagnosis of schizophrenia and less likely to be diagnosed with mood disorder. Patient race was similarly related to the research diagnoses produced in the clinician-structured research condition (phase one). Although less pronounced, a higher percentage of African Americans than whites received a diagnosis of schizophrenia using the semi-structured DSM-III-R Symptom Checklist (phase two). The black-white distribution for mood disorders showed that whites were more likely than blacks to be diagnosed with mood disorder.

Living alone and neighborhood characteristics as predictors of social support in late life.

OBJECTIVES: The purpose of this study was to devise and test a conceptual model that explains how neighborhood quality, fear of crime, and received emotional support affect an elderly person's expectations of future assistance should the need arise (i.e., anticipated support). METHODS: Using a nationwide survey of older adults, a series of nested latent variable models was tested to determine if the social support process differs between older adults living alone and those living with others. RESULTS: Consistent with a social ecological perspective, data suggest that anticipated support is lower among elders who live in deteriorated neighborhoods than among older adults who live in well-maintained neighborhoods. Moreover, the deleterious effects of run-down neighborhoods appear to be especially pronounced for older adults who live alone. DISCUSSION: Select constructs that link deteriorated neighborhoods with anticipated support are explored. Suggestions for future research are made.

Recruitment and retention of African American patients for clinical research: an exploration of response rates in an urban psychiatric hospital.

The issues related to recruiting African American psychiatric inpatients are discussed in the context of a study on the influence of ethnicity on psychiatric diagnosis. Ethnically diverse psychiatric residents interviewed 960 Black and White inpatients in 2 urban psychiatric hospitals. Despite the obstacles cited in the literature about recruiting and retaining African Americans into research, 78% of this sample were African American. In addition, interview completion and refusal rates did not differ by patient ethnicity. Results suggest that matching interviewer and patient ethnicity did not influence African Americans' likelihood of participating in or of refusing an interview. This article summarizes a number of guidelines that others may find useful in conducting clinical research with African Americans, ranging from the formation of academic-public liaisons to interviewer training.

Differential effects of left versus right seizure focus on human hippocampal evoked responses.

Hippocampal evoked potentials were recorded using the P3 tonal oddball paradigm in 30 patients with unilateral temporal lobe seizure focus. Spectral power of the evoked potentials was decreased on the side of seizure focus, but this reduction was much greater when the focus was on the left. The effect of left/right focus does not appear to be due to group differences in age, sex, seizure duration, or operative pathology. Remote or finer left/right structural differences or differential left/right hippocampal processing for the sequential tonal task are possible explanations.

Effects of scopolamine on visual evoked potentials in aging and dementia.

The unusual combination of a normal pattern reversal VEP and a delayed flash VEP has been reported in patients with dementia of Alzheimer's type (DAT). Hyoscine hydrobromide has been reported to produce a similar VEP abnormality in young, healthy subjects. In the present study, we assessed the relative sensitivity of DAT patients and healthy young, middle-aged and elderly subjects to temporary cholinergic blockade. We report VEP latency values following 3 doses of scopolamine and after a peripheral anticholinergic agent. Flash P2 latency was not significantly slower in DAT patients than in the healthy elderly. Scopolamine increased P2 latency in the young controls but did not affect any other group. The pattern reversal P100 was normal in DAT, and a significant increase in latency occurred following scopolamine administration in both the control and patient groups.

Differential cognitive effects of terfenadine and chlorpheniramine.

The H1-histamine antagonist, terfenadine, has been proposed to have reduced cognitive side effects. In the present study, the relative cognitive effects of terfenadine, 60 mg, chlorpheniramine maleate, 8 mg, and placebo were tested with a double-blind, randomized, three-period crossover design in 24 healthy adult subjects. The dependent variable was latency of the P3-evoked potential. The P3 is a cognitively evoked electroencephalographic response that is an objective and sensitive measure of sustained attention and cerebral processing speed. Disease and drug states that adversely affect the central nervous system can slow P3 latency. For example, the centrally active anticholinergic scopolamine slows cognitive processing speed and prolongs P3 latency. P3 latency (millisecond) means (+/- mean standard error) were pretreatment, 310 (+/- 1.7; placebo, 313 (+/- 3); terfenadine, 320 (+/- 3); and chlorpheniramine, 333 (+/- 3). The findings suggest that terfenadine may be particularly advantageous in patients who require alertness and intact cognitive abilities.

Hemisphere asymmetry for eye gaze mechanisms.

To investigate left/right asymmetries in cerebral gaze mechanisms, eye deviation was evaluated in 90 patients following intracarotid sodium amylobarbitone injections. For right-handed subjects with left cerebral language dominance, the occurrence and severity of eye deviation were greater for right versus left hemisphere injections. In contrast, subjects with mixed cerebral dominance for language/handedness exhibited no left/right difference in the incidence of eye deviation. The results are consistent with right cerebral dominance for attentional/intentional mechanisms directed at external space. Further analysis suggests that the cerebral asymmetry for gaze may be due to an evolutionary loss of attentional/intentional mechanisms by the left cerebral hemisphere as language function developed.

Right cerebral specialization for tactile attention as evidenced by intracarotid sodium amytal.

Although several components of neglect syndrome have been reported to occur more frequently following right cerebral lesions, a right cerebral predominance for directed tactile attention has not been demonstrated. The intracarotid sodium amytal procedure (ISA, or Wada test) offers the opportunity to investigate differential effects for symmetric acute dysfunction of each cerebral hemisphere in each subject. In the present study, 18 patients undergoing preoperative evaluation for epilepsy surgery were trained in a nonverbal task of tactile attention. Left/right mean ISA dosages and left/right tactile test times postinjection were matched. Results revealed more correct responses following left ISA, and greater tactile inattention with more extinction-type responses following right ISA. No effect of seizure focus, sex, order of injection, or dosage was present. The finding that tactile inattention occurs more frequently with right cerebral dysfunction is consistent with right cerebral dominance for scanning attentional mechanisms directed at the external milieu.

Spectral analysis of sphenoidal evoked potentials predicts epileptic focus.

Sphenoidal evoked potentials (SpEPs) were recorded in 14 patients with intractable temporal lobe epilepsy. Twelve patients had electrographically proven unilateral seizure onset (five left, seven right). Two patients had partial complex seizures and unilateral mesial temporal lobe lesions shown by magnetic resonance imaging (MRI). Thirteen patients subsequently underwent temporal lobectomy. SpEPs were recorded using the P3 tonal oddball paradigm from sphenoidal electrodes referenced to scalp electrodes (i.e., T3, T4, C3, C4, Cz) and were subjected to spectral analysis for whole band (1-12.6 Hz) power. A significant relationship was found for side of seizure focus and reduced spectral power of the sphenoidal-temporal target SpEPs. In 10 of 14 patients, SpEP spectral power was less from the "epileptogenic" than from the "nonepileptogenic" temporal lobe. Of the remaining 4 patients, 2 had bilaterally equal spectral power, and 2 had lower SpEP power from the nonepileptogenic side. Postoperatively, all 13 patients are seizure-free except for the 2 patients with reduced SpEP power opposite to the ictal onset and 1 patient with fluctuations in SpEP asymmetries. Spectral analysis of SpEPs appears to have utility in the assessment of temporal lobe dysfunction and thus in the preoperative evaluation for epilepsy surgery.